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I'm 16-years-old and have a curved spine because of a deformed vertebral bone. My parents could never afford surgery to have the half-vertebra removed. Now I'm stuck in an ugly curve with a painful spine. When I leave home, the first thing I'm going to do is get help for this problem. What could be done for me?
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Scoliosis (curvature of the spine) can occur for no apparent reason. But it can also develop when there are deformities of the bone such as you describe. Congenital deformities such as a hemivertebra leave the spine unstable and curving to one side because only half of the spinal bone formed. The other side is missing, which causes the bones on either side to tip or collapse to one side.
If this problem is diagnosed early (before age six), the deformed half of a vertebra can be removed surgically. Studies show that these children have excellent results with this procedure.
But this approach doesn't work when the problem isn't recognized until the child is older or (as in your case), treatment wasn't possible for some reason. Treatment is especially challenging if the spine has matured (bone growth is complete or nearly complete).
Usually by age 16, most girls have reached skeletal maturity. Boys may still continue growing for a few more years but their skeletal maturity is nearly complete by age 16 to 18, too.
Surgeons at the University School of Medicine in Shanghai, China recently reported on a new technique to correct the problem of untreated congenital spinal deformity in older children and teens. It's called a posterior unilateral pedicle subtraction osteotomy of hemivertebra.
The surgeons entered the spine from the back rather than the front of the body. That's what posterior means. Unilateral tells us only one side is operated on. And an osteotomy is removing a wedge-shaped piece of bone.
In this procedure, the surgeon removed this pie-shaped piece from the deformed hemivertebra. Along with the piece of vertebral bone, they also removed the transverse process -- that's the bony bump you feel along the back of your spine. The effect is to allow the remaining edges of bone to collapse toward each other.
The surgeon guided either side of the remaining bone fragments to move together -- enough to close the gap formed by removing the piece of bone. The end result is correction of the curve. It's called a subtraction osteotomy because only a portion of the deformed vertebra is removed or taken away (subtracted).
Then screws and rods are placed above and below the level operated on to hold them in place until healing occurs. This part of the procedure is called corrective fixation or instrumented fusion.
Whether or not you are a good candidate for this (or some other procedure) must be determined by an orthopedic surgeon who specializes in spinal surgeries. Your first step is to find someone who treats children and teens with scoliosis and have an examination. Once you have been examined and imaging studies have been analyzed, the surgeon will be able to tell you what your treatment options may be.
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